Urology robotics

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Urology Robotics, or URobotics, is a new interdisciplinary field for the application of robots in urology and for the development of such systems and novel technologies in this clinical discipline. [1] [2] Urology is among the medical fields with the highest rate of technology advances, which for several years has included the use medical robots. [3]

Applications

The first surgical robot approved by the FDA is the da Vinci system. [4] Even though this was designed to assist in general Laparoscopy, most of its application are in the urology field for radical prostatectomy. Pioneered at the Vattikuti Urology Institute, robotic radical prostatectomy has now become the gold standard for the treatment of prostate cancer. [5]

Other, URobotic systems are under development. These include image-guided robots that, in addition to the direct visual feedback, use medical images for guiding the intervention. Since MRI provides enhanced visualization of soft-tissues compared to x-ray-based imaging, MRI compatible robots are being developed to assist the physician in performing the intervention in the MRI scanner. If prostate cancer lesions can be delineated in the image, robots can accurately target those lesions for biopsy or focal ablations.

Related Research Articles

<span class="mw-page-title-main">Urology</span> Medical specialty

Urology, also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary-tract system and the reproductive organs. Organs under the domain of urology include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs.

<span class="mw-page-title-main">Prostate</span> Gland of the male reproductive system in most mammals

The prostate is both an accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found in all male mammals. It differs between species anatomically, chemically, and physiologically. Anatomically, the prostate is found below the bladder, with the urethra passing through it. It is described in gross anatomy as consisting of lobes and in microanatomy by zone. It is surrounded by an elastic, fibromuscular capsule and contains glandular tissue, as well as connective tissue.

<span class="mw-page-title-main">Prostatectomy</span> Surgical removal of all or part of the prostate gland

Prostatectomy is the surgical removal of all or part of the prostate gland. This operation is done for benign conditions that cause urinary retention, as well as for prostate cancer and for other cancers of the pelvis.

<span class="mw-page-title-main">Robot-assisted surgery</span> Surgical procedure

Robot-assisted surgery or robotic surgery are any types of surgical procedures that are performed using robotic systems. Robotically assisted surgery was developed to try to overcome the limitations of pre-existing minimally-invasive surgical procedures and to enhance the capabilities of surgeons performing open surgery.

<span class="mw-page-title-main">Radical retropubic prostatectomy</span>

Radical retropubic prostatectomy is a surgical procedure in which the prostate gland is removed through an incision in the abdomen. It is most often used to treat individuals who have early prostate cancer. Radical retropubic prostatectomy can be performed under general, spinal, or epidural anesthesia and requires blood transfusion less than one-fifth of the time. Radical retropubic prostatectomy is associated with complications such as urinary incontinence and impotence, but these outcomes are related to a combination of individual patient anatomy, surgical technique, and the experience and skill of the surgeon.

<span class="mw-page-title-main">Laparoscopic radical prostatectomy</span>

Laparoscopic radical prostatectomy (LRP) is a form of radical prostatectomy, an operation for prostate cancer. Contrasted with the original open form of the surgery, it does not make a large incision but instead uses fiber optics and miniaturization.

da Vinci Surgical System Robotic surgical system

The da Vinci Surgical System is a robotic surgical system that uses a minimally invasive surgical approach. The system is manufactured by the company Intuitive Surgical. The system is used for prostatectomies, and increasingly for cardiac valve repair, and for renal and gynecologic surgical procedures.

<span class="mw-page-title-main">Mani Menon</span>

Mani Menon, born 9 July 1948 in Trichur, India, is an American surgeon whose pioneering work has helped to lay the foundation for modern Robotic Cancer Surgery. He is the founding director and the Raj and Padma Vattikuti Distinguished Chair of the Vattikuti Urology Institute at the Henry Ford Hospital in Detroit, MI, where he established the first cancer-oriented robotics program in the world. Menon is widely regarded for his role in the development of robotic surgery techniques for the treatment of patients with prostate, kidney, and bladder cancers, as well as for the development of robotic kidney transplantation.
Menon is the recipient of the Gold Cystoscope award, Hugh Hampton Young award, the Keyes Medal, the prestigious B.C. Roy award.

<span class="mw-page-title-main">Ashutosh Tewari</span> American urologist, oncologist

Ashutosh K. Tewari is the chairman of urology at the Icahn School of Medicine at Mount Sinai Hospital in New York City. He is a board certified American urologist, oncologist, and principal investigator. Before moving to the Icahn School of Medicine in 2013, he was the founding director of both the Center for Prostate Cancer at Weill Cornell Medical College and the LeFrak Center for Robotic Surgery at NewYork–Presbyterian Hospital. Dr. Tewari was the Ronald P. Lynch endowed Chair of Urologic Oncology and the hospital's Director of Robotic Prostatectomy, treating patients with prostate, urinary bladder and other urological cancers. He is the current President of the Society for Urologic Robotic Surgeons (SURS) and the Committee Chair of the Prostate Program. Dr. Tewari is a world leading urological surgeon, and has performed over 10,000 robotically assisted procedures using the da Vinci Surgical System. Academically, he is recognized as a world-renowned expert on urologic oncology with over 250 peer reviewed published papers to his credit; he is on such lists as America's Top Doctors, New York Magazine's Best Doctors, and Who's Who in the World. In 2012, he was given the American Urological Association Gold Cystoscope Award for "outstanding contributions to the field of urologic oncology, most notably the treatment of prostate cancer and the development of novel techniques to improve the outcomes of robotic prostatectomy."

Douglas S. Scherr, M.D. is an American surgeon and specialist in Urologic Oncology. He is currently the Clinical Director of Urologic Oncology at Weill Cornell Medicine. He also holds an appointment at the Rockefeller University as a Visiting Associate Physician. Scherr was the first physician at Cornell to perform a robotic prostatectomy as well as a robotic cystectomy.

Treatment for prostate cancer may involve active surveillance, surgery, radiation therapy – including brachytherapy and external-beam radiation therapy, proton therapy, high-intensity focused ultrasound (HIFU), cryosurgery, hormonal therapy, chemotherapy, or some combination. Treatments also extend to survivorship based interventions. These interventions are focused on five domains including: physical symptoms, psychological symptoms, surveillance, health promotion and care coordination. However, a published review has found only high levels of evidence for interventions that target physical and psychological symptom management and health promotion, with no reviews of interventions for either care coordination or surveillance. The favored treatment option depends on the stage of the disease, the Gleason score, and the PSA level. Other important factors include the man's age, his general health, and his feelings about potential treatments and their possible side-effects. Because all treatments can have significant side-effects, such as erectile dysfunction and urinary incontinence, treatment discussions often focus on balancing the goals of therapy with the risks of lifestyle alterations.

Dong-A University Hospital (동아대학교의료원) is a major general hospital affiliated with Dong-A University in Busan, South Korea.

<span class="mw-page-title-main">Roger Kirby</span> British surgeon

Roger Sinclair Kirby FRCS(Urol), FEBU is a British retired prostate surgeon and professor of urology, researcher, writer on men's health and prostate disease, founding editor of the journal Prostate Cancer and Prostatic Diseases and Trends in Urology and Men's Health and a fundraiser for prostate disease charities, best known for his use of the da Vinci surgical robot for laparoscopic prostatectomy in the treatment of prostate cancer. He is a co-founder and president of the charity The Urology Foundation (TUF), vice-president of the charity Prostate Cancer UK, trustee of the King Edward VII's Hospital and as of 2020 is president of the Royal Society of Medicine (RSM), London.

<span class="mw-page-title-main">Michael Stifelman</span> American physician and urologist

Michael D. Stifelman is an American physician and urologist, known for his work in upper tract urinary reconstructive surgery and use of multi- and single-port robotic surgical technology to perform complex cancer and non-cancer urological procedures. An innovator in the field of urological surgery, Dr. Stifelman leads the Center of Excellence for robotic surgery at Hackensack University Medical Center in Hackensack, New Jersey, and serves as chair of the hospital's Department of Urology.

Narmada Prasad Gupta is an Indian urologist, medical researcher, writer and the chairman of Academics and Research Division Urology at the Medanta, the Medicity, New Delhi. He is credited with over 10,000 urological surgical procedures and the highest number of urology robotics (URobotic) surgeries in India. He is a former head of the department of urology of the All India Institute of Medical Sciences Delhi and a former president of the Urological Society of India. He received the Dr. B. C. Roy Award, the highest Indian award in the medical category, from the Medical Council of India in 2005. The government of India awarded him the fourth highest civilian honour of the Padma Shri, in 2007, for his contributions to Indian medicine.

<span class="mw-page-title-main">Vipul Patel</span>

Vipul R. Patel, FACS is the founder and Medical Director of the Florida Hospital Global Robotics Institute, founder and Vice President of the Society of Robotic Surgery, and founder and Editor Emeritus of The Journal of Robotic Surgery. He is board certified by the American Urological Association and specializes in robotic surgery for prostate cancer. As of February, 2018 he performed his 11,000th robotic-assisted prostatectomy. The large volume of prostatectomies he has performed has enabled him to amass a large amount of statistical evidence regarding the efficacy of robotic techniques which has been used in developing and refining techniques. Patel credits the use of robotic assisted surgery with helping surgeons achieve better surgical outcomes with the "trifecta" of cancer control, continence and sexual function. In the course of his career Patel has led and participated in studies that have resulted in developing improved outcomes for robotic surgery and urologic treatment.

<span class="mw-page-title-main">Ben Challacombe</span> British urological surgeon

Benjamin James Challacombe is a British consultant urological surgeon at Guy's & St Thomas' Hospitals, and at King’s College London, who specialises in the treatment of kidney and prostatic disease using robotic surgery. In 2005, he was part of the team that published the results of a randomised controlled trial of human versus telerobotics in the field of urology and renal transplant, one of the first of its kind.

Declan G. Murphy, FRACS, FRCS, is a urologist, director of the unit for genitourinary oncology and robotic surgery at the Peter MacCallum Cancer Centre in Melbourne, Australia, professor at the Sir Peter MacCallum Department of Oncology at the University of Melbourne, and associate editor of the British Journal of Urology International. In 2010 he introduced robotic surgery for urology to the public sector health services in Victoria, Australia.

Anthony James Costello, FRACS, FRCSI, is an Australian urologist. He served as head of the department of urology at the Royal Melbourne Hospital, Australia. He established the first robotic prostate cancer surgery programme in Australia and published the first series of men who had laser surgery for benign prostate enlargements.

Mark Emberton is a urologist and prostate cancer research specialist using novel imaging techniques and minimally invasive treatments to improve diagnosis and treatment of prostate cancer.

References

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  2. Shah J, Mackay S, Rockall T, Vale J, Darzi A (Sep 2001). "'Urobotics': robots in urology". BJU Int. 88 (4): 313–20. doi:10.1046/j.1464-410X.2001.02317.x. PMID   11564012.
  3. "The Role of Robotics | UCSF Department of Urology". urology.ucsf.edu. Retrieved 2017-09-20.
  4. Keown, Alex. "Da Vinci Xi Surgical System opens new doors for doctors and patients". TheCourierExpress.com. Retrieved 2017-09-20.
  5. Tewari A, Peabody J, Sarle R, et al. (Oct 2002). "Technique of da Vinci robot-assisted anatomic radical prostatectomy". Urology. 60 (4): 569–72. doi:10.1016/S0090-4295(02)01852-6. PMID   12385908.